With the announcement that BCMA negotiators and the provincial government had reached a tentative agreement only a few days prior to this year’s Annual General Meeting, naturally the talk of the meeting was negotiations (the results of the referendum on the proposed agreement were not available at press time). About 165 of your intrepid colleagues spent their Saturday hearing reports, asking questions, and catching up with friends and colleagues at Vancouver’s Pan Pacific Ho­tel located on the downtown waterfront.

In his report, outgoing President Dr Nasir Jetha said he was pleased to end on a positive note, calling the conclusion of negotiations a “significant achievement within the economic context. It continues the collaborative initiatives of the General Practice Services Committee, the Specialist Services Committee, the Rural Joint Standing Committee, and others, and provides special funding for sections with challenges around recruitment and retention, such as anesthesia.”

Once the Physician Master Agreement is concluded, it will be the end of an era for BCMA negotiations leadership, with both Dr Brad Fritz and Mr Geoff Holter leaving their positions. Dr Fritz has been chair of the Statutory Negotiating Committee for a total of 15 years (with a 17-year break between two terms), and Mr Holter has been the BCMA’s chief negotiator and executive director of the Negotiations Department for 17 years. Both received warm thanks and enthusiastic rounds of applause in appreciation of the work they have done on behalf of BC physicians over the years.

There were a few questions regarding the Wang v. BCMA court case at various points through the meeting. It was pointed out that the BCMA did not initiate the legal proceedings, but is obliged to respond, and the individuals named clearly need to defend themselves. The cost of the defence was queried, and, in his report as chair of the Audit and Finance Committee, Dr Brian Brodie reported the costs, which members can read in the BCMA Annual Report 2011–12. The trial com­menced 30 January 2012 and continued for 5 weeks.

In the rest of his report, Dr Brodie showed that in 2011 expenses increas­ed by about 20% over 2010; in part because there were a number of staff positions unfilled in 2010 but filled in 2011, and both consulting and legal costs were higher. Consulting fees, he noted, went primarily to support the Specialist Services Committee, the Shared Care Committee, and the General Practice Services Committee ($2.2 million). But despite the in­crease in costs over 2010, the bottom line is that the BCMA is $1.75 million in the black.

On the subject of membership dues, Dr Brodie explained that dues for 2012 were raised by $25 (a 2% increase). The last time there was a dues increase was in 2005 (a 1% increase). Given the overall financial stability of the Association, the Audit and Finance Committee recommended no dues increase for 2013. Finally, members in attendance elected Drs Mark Corbett, Michael Curry, and David Jones as the three members of the Audit and Finance Committee.

Much of the business of the BCMA is reported in the 2011–12 BCMA White Report, the annual reports of the CEO, Council on Health Promotion, committees and councils, sections and societies, and affiliated organizations of the BCMA. It’s recommended reading for those interested in the dozens of initiatives undertaken on your behalf. The White Report is available for download here, or e-mail communications@bcma.bc.ca for a printed copy.

“I want to talk to you about some of the issues that are on my mind as I begin my term as president of the BCMA. I’m going to start with what has been on all of our minds: negotiating the new Physician Master Agreement. I am delighted to tell you that on Friday, after 2 years of negotiations, we concluded a new Master Agreement, and a membership ref­erendum ballot will be in the mail soon.

We should salute our outgoing president, Dr Nasir Jetha; our chief negotiator, Mr Geoff Holter; and the BCMA staff who have worked so very hard to conclude an agreement. The agreement strengthens the collaborative relationship with government that so many have worked so hard to build and maintain. It does not include the rollbacks that our colleagues in On­tario have had imposed on them.

Once our new Master Agreement is ratified by our members and we have an agreement that serves all physicians and patients in BC, my first priority as your president will be to work with the Board and staff to rebuild member confidence in our Association.

“Many of you know that I’m a straight-ahead type and in that light I want to comment on something that has been on my mind. I’m sure you’re aware there’s been some dissatisfaction among certain specialties in the province. We’re all frustrated with the things that prevent us from providing timely and professional care to our patients. But we must all play by the rules. Agreements are in place to protect doctors—to ensure everyone is treated fairly and equitably.

The BCMA is committed to representing all doctors in the province in a fair, balanced, and respectful way. That includes honoring agreements once they are signed. We have to recognize that once we have an agreement, we’re going to have to let our members express their feelings about what has or hasn’t been achieved, and what they want to see going forward.

“Now I’d like to talk about change and how we manage change as an association, personally, and in our profession. We all come into the medical profession for our own reasons. For some it’s a calling; for some it’s a good career. For me, it started when I received my first doctor’s kit as a toddler—that was it. I knew what I wanted to be, and I never wavered. Ultimately we all want to do the same thing—provide the very best care we can for our patients. But like all of you I’m becoming increasingly concerned about our ability to provide that ‘best care’ under the circumstances.

“So many things are changing. Sometimes the changes are good, like the new programs coming out of the Specialist Services Committee and the GPSC. For example, under the SSC, the telephone consultation fee is finally compensating specialists for the advice they provide us GPs over the phone. That’s good and fair. Through the GPSC, family doctors are now receiving chronic care and complex disease management fees. Where would general practice be without those fees?

“Some of the increases to scopes of practice might be helpful. For ex­ample, more pharmacists will be giving vaccinations to patients. That can be helpful during flu season, or with the recent whooping cough outbreak. But we need to make sure the patients’ doctors are notified. We need to make sure that we’re all working together in the best interest of the patient.

One of the changes we’d probably all like to see is more use of physician assistants. I like to think of them as physician extenders, because they extend our ability to provide care to our patients. They don’t work independently outside a physician-led team—they’re part of the team. This concept is already working well in the US and other areas.”—Shelley Ross, MD